61 research outputs found
Sex differences in the course of implantable cardioverter defibrillator concerns (Results from the Danish national DEFIB-WOMEN study)
New onset anxiety and depression in patients with an implantable cardioverter defibrillator during 24Â months of follow-up (data from the national DEFIB-WOMEN study)
Effect of implantable cardioverter-defibrillators in patients with non-ischaemic systolic heart failure and concurrent coronary atherosclerosis
AIMS: Prophylactic implantable cardioverterâdefibrillators (ICD) reduce mortality in patients with ischaemic heart failure (HF), whereas the effect of ICD in patients with nonâischaemic HF is less clear. We aimed to investigate the association between concomitant coronary atherosclerosis and mortality in patients with nonâischaemic HF and the effect of ICD implantation in these patients. METHODS AND RESULTS: Patients were included from DANISH (Danish Study to Assess the Efficacy of Implantable Cardioverter Defibrillators in Patients with NonâIschaemic Systolic Heart Failure on Mortality), randomizing patients to ICD or control. Study inclusion criteria for HF were left ventricular ejection fraction â¤Â 35% and increased levels (>200 pg/mL) of Nâterminal proâbrain natriuretic peptide. Of the 1116 patients from DANISH, 838 (75%) patients had available data from coronary angiogram and were included in this subgroup analysis. We used Cox regression to assess the relationship between coronary atherosclerosis and mortality and the effect of ICD implantation. Of the included patients, 266 (32%) had coronary atherosclerosis. Of these, 216 (81%) had atherosclerosis without significant stenoses, and 50 (19%) had significant stenosis. Patients with atherosclerosis were significantly older {67 [interquartile range (IQR) 61â73] vs. 61 [IQR 54â68] years; P < 0.0001}, and more were men (77% vs. 70%; P = 0.03). During a median followâup of 64.3 months (IQR 47â82), 174 (21%) of the patients died. The effect of ICD on allâcause mortality was not modified by coronary atherosclerosis [hazard ratio (HR) 0.94; 0.58â1.52; P = 0.79 vs. HR 0.82; 0.56â1.20; P = 0.30], P for interaction = 0.67. In univariable analysis, coronary atherosclerosis was a significant predictor of allâcause mortality [HR, 1.41; 95% confidence interval (CI), 1.04â1.91; P = 0.03]. However, this association disappeared when adjusting for cardiovascular risk factors (age, gender, diabetes, hypertension, smoking, and estimated glomerular filtration rate) (HR 1.05, 0.76â1.45, P = 0.76). CONCLUSIONS: In patients with nonâischaemic systolic heart failure, ICD implantation did not reduce allâcause mortality in patients either with or without concomitant coronary atherosclerosis. The concomitant presence of coronary atherosclerosis was associated with increased mortality. However, this association was explained by other risk factors
Severity of Brugada syndrome disease manifestation and risk of new-onset depression or anxiety:a Danish nationwide study
Long-term cardiovascular outcomes among immigrants and non-immigrants in cardiac resynchronization therapy:a nationwide study
Atrial pacing minimization in sinus node dysfunction and risk of incident atrial fibrillation:a randomized trial
An anterior left ventricular lead position is associated with increased mortality and non-response in cardiac resynchronization therapy
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